Visual library
Diagrams, step-by-step procedures, timelines and comparisons — see how fertility and treatment work.
68 visuals
Female reproductive organs
Tap a label to learn about that part.
Front view of the womb, tubes and ovaries. Tap any label to learn what it does.
Source: KedVia original diagram · KedVia medical illustration team
Male reproductive organs
Tap a label to learn about that part.
Where sperm are made, matured and mixed with fluid. Tap a label to learn more.
Source: KedVia original diagram · KedVia medical illustration team
Parts of a sperm
Tap a label to learn about that part.
A sperm is about 0.05 mm long. Each part has a job in reaching and entering the egg.
Source: KedVia original diagram · KedVia medical illustration team
How sperm are made
Step 1 of 6
Stem cells
Inside tiny tubes in the testis, stem cells (spermatogonia) divide all through adult life.
Making new sperm takes about 2½ months, so lifestyle changes show in a semen test after about 3 months.
Source: KedVia original diagram · KedVia medical illustration team
Hormones across a 28-day cycle
How the four main hormones rise and fall. The LH surge triggers ovulation about 24–36 hours later. Cycle lengths vary from person to person.
Source: KedVia original diagram · KedVia medical illustration team
How an egg's follicle grows
Primordial
Resting egg with a flat layer of cells. Women are born with all of these.
Each egg sits in a tiny fluid sac called a follicle. Only the follicles visible on scan (antral follicles) are counted as AFC.
Source: KedVia original diagram · KedVia medical illustration team
From ovulation to implantation
Step 1 of 6
Egg released
Around mid-cycle the mature follicle releases one egg. It lives for about 12–24 hours.
The first 10 days of a natural pregnancy, step by step.
Source: KedVia original diagram · KedVia medical illustration team
Implantation in the womb lining
Tap a label to learn about that part.
The blastocyst hatches out of its shell and embeds into the thick, prepared lining.
Source: KedVia original diagram · KedVia medical illustration team
Early pregnancy milestones
Step 1 of 5
Implantation
Days 6–10 after ovulation the embryo attaches to the lining.
Typical timings after embryo transfer or ovulation. Your doctor will guide your own schedule.
Source: KedVia original diagram · KedVia medical illustration team
Common womb problems compared
Side-by-side drawings of a normal womb and common conditions that can affect fertility.
Source: KedVia original diagram · KedVia medical illustration team
Types of fibroids
Where a fibroid sits matters more than its size.
Source: KedVia original diagram · KedVia medical illustration team
Endometriosis in the pelvis
Tap a label to learn about that part.
Tissue similar to the womb lining grows outside the womb, causing pain, cysts and scar tissue.
Source: KedVia original diagram · KedVia medical illustration team
Endometriosis vs adenomyosis
| Where | Outside the womb (ovaries, pelvis) | Inside the womb's muscle wall |
|---|---|---|
| Main symptoms | Painful periods, pain during sex, infertility | Heavy, painful periods, bulky womb |
| How found | Ultrasound / MRI; confirmed by laparoscopy | Ultrasound or MRI |
| Treatment options | Pain relief, hormones, surgery, IVF | Pain relief, hormones, sometimes surgery, IVF |
Two related but different conditions.
Source: KedVia original diagram · KedVia medical illustration team
Normal ovary vs polycystic-appearing ovary
In PCOS/PMOS the ovary often shows many small follicles that stop growing. They are not true cysts.
Source: KedVia original diagram · KedVia medical illustration team
How PCOS/PMOS affects ovulation
Insulin resistance
The body needs more insulin to control sugar.
More male-type hormones (androgens)
Can cause acne, extra hair and hair thinning.
Follicles stop growing
Many small follicles, but none becomes dominant.
No or irregular ovulation
Periods become irregular or stop.
What helps
Even 5–10% weight loss, activity, and ovulation tablets like letrozole under a doctor's care.
A cycle of hormone imbalance — which weight loss, exercise and medicines can help break.
Source: KedVia original diagram · KedVia medical illustration team
Open vs blocked tubes
The tubes must be open for egg and sperm to meet.
Source: KedVia original diagram · KedVia medical illustration team
What happens during an HSG test
Step 1 of 6
Right timing
Booked after bleeding stops and before ovulation, so you are not pregnant.
A 15–30 minute X-ray test done after your period ends and before ovulation (about day 6–11).
Source: KedVia original diagram · KedVia medical illustration team
First fertility tests — for both partners
First visit together
History, periods, past illness or surgery, and lifestyle for both.
Her tests
Day 2–3 hormones (FSH, LH, AMH, TSH, prolactin), pelvic ultrasound with follicle count.
His tests
Semen analysis after 2–7 days of no ejaculation; hormones if needed.
Tube check
HSG or sono-HSG, or laparoscopy if needed.
Plan together
The doctor explains the cause found and the simplest suitable treatment.
Both partners are checked together from the start. Male factor is involved in about half of couples.
Source: KedVia original diagram · KedVia medical illustration team
Giving a semen sample
Step 1 of 5
No ejaculation for 2–7 days
Too short or too long can change the result.
Simple steps for an accurate result.
Source: KedVia original diagram · KedVia medical illustration team
Semen report: WHO 2021 lower reference limits
| Volume | 1.4 mL |
|---|---|
| Concentration | 16 million per mL |
| Total count | 39 million per sample |
| Total motility | 42% |
| Progressive motility | 30% |
| Normal shape (morphology) | 4% |
| Vitality (live sperm) | 54% |
Values below these are less common in fertile men — but one value alone does not decide fertility.
Source: KedVia original diagram · KedVia medical illustration team
IUI: placing washed sperm in the womb
Tap a label to learn about that part.
A thin soft catheter places prepared sperm high in the womb around ovulation.
Source: KedVia original diagram · KedVia medical illustration team
IUI step by step
Step 1 of 7
Baseline scan
Day 2–3 of your period.
One IUI cycle usually needs 3–5 clinic visits.
Source: KedVia original diagram · KedVia medical illustration team
The IVF journey in 9 steps
Step 1 of 9
Initial fertility assessment
Tests for both partners, AMH, scan and counselling to plan the right protocol.
A full IVF cycle takes about 4–6 weeks from start to pregnancy test.
Source: KedVia original diagram · KedVia medical illustration team
Stimulation and monitoring
Step 1 of 6
Day 2–3 scan
Checks the ovaries are quiet and counts antral follicles.
How your doctor watches the follicles grow safely.
Source: KedVia original diagram · KedVia medical illustration team
Egg retrieval
Tap a label to learn about that part.
A fine needle passes through the vaginal wall into each follicle under ultrasound guidance. It takes 15–30 minutes under short anaesthesia.
Source: KedVia original diagram · KedVia medical illustration team
Conventional IVF fertilisation
Tap a label to learn about that part.
Each egg is placed with tens of thousands of prepared sperm in a dish; one sperm enters naturally.
Source: KedVia original diagram · KedVia medical illustration team
ICSI: one sperm injected into the egg
Tap a label to learn about that part.
Under a powerful microscope, the embryologist holds the egg and injects one selected sperm.
Source: KedVia original diagram · KedVia medical illustration team
ICSI step by step
Step 1 of 5
Cleaning the egg
Cumulus cells are removed to check maturity.
Used mainly when sperm count or movement is very low, or after failed fertilisation.
Source: KedVia original diagram · KedVia medical illustration team
Conventional IVF vs ICSI
| How sperm enters | Naturally, in the dish | Injected by the embryologist |
|---|---|---|
| Best for | Normal or mildly low sperm | Very low count/motility, surgically retrieved sperm, past failed fertilisation |
| Sperm needed | Thousands per egg | One per egg |
| Extra cost | — | Usually a little more |
Both are IVF; they differ only in how the egg is fertilised.
Source: KedVia original diagram · KedVia medical illustration team
Inside the embryology lab
Step 1 of 6
Finding the eggs
Follicle fluid is checked under a microscope within minutes of retrieval.
What happens to your eggs and embryos while you wait.
Source: KedVia original diagram · KedVia medical illustration team
Embryo development: day 0 to day 6
Day 1 · Fertilised egg
Two pronuclei — one from the egg, one from the sperm.
Tap each day to see how the embryo changes. Not every embryo reaches every stage — this is normal.
Source: KedVia original diagram · KedVia medical illustration team
Parts of a blastocyst
Tap a label to learn about that part.
A day 5–6 embryo. Grading looks at each of these parts.
Source: KedVia original diagram · KedVia medical illustration team
How blastocysts are graded (Gardner system)
| Expansion 1–2 | Early blastocyst; cavity forming |
|---|---|
| Expansion 3 | Full blastocyst; cavity fills the embryo |
| Expansion 4 | Expanded; shell becoming thin |
| Expansion 5–6 | Hatching or fully hatched |
| ICM / TE grade A | Many tightly packed cells — best |
| ICM / TE grade B | Several cells — good |
| ICM / TE grade C | Few cells — lower chance, but still possible |
A grade like '4AA' = expansion 4, ICM grade A, TE grade A. Lower grades can still lead to a healthy baby.
Source: KedVia original diagram · KedVia medical illustration team
Day 3 vs day 5 embryo transfer
| Cells | About 6–8 | About 100+ |
|---|---|---|
| Selection | Less information | Easier to pick the strongest embryo |
| Chance per transfer | Lower | Usually higher |
| Risk | Embryos reach transfer more often | Some embryos stop before day 5 |
Your embryologist and doctor choose based on how many embryos you have and how they grow.
Source: KedVia original diagram · KedVia medical illustration team
Embryo transfer
Tap a label to learn about that part.
A soft catheter places the embryo in the upper womb under abdominal ultrasound. It feels like a Pap test and takes about 10 minutes.
Source: KedVia original diagram · KedVia medical illustration team
Frozen embryo transfer (FET)
Step 1 of 6
Choose the cycle
A natural cycle (tracking your own ovulation) or a medicated cycle (oestrogen tablets/patches).
Using a frozen embryo in a later, calmer cycle.
Source: KedVia original diagram · KedVia medical illustration team
Fresh vs frozen embryo transfer
| When | 3–5 days after egg retrieval | In a later cycle |
|---|---|---|
| OHSS risk | Higher if many follicles | Lower — ovaries rest first |
| Lining | Affected by stimulation hormones | Prepared separately |
| Extra cost | None | Freezing, storage and FET cycle |
Both can work very well. Your doctor advises based on your hormones and OHSS risk.
Source: KedVia original diagram · KedVia medical illustration team
Laser-assisted hatching
Tap a label to learn about that part.
A precise laser makes a small opening in the embryo's shell to help it hatch. Useful only in selected cases.
Source: KedVia original diagram · KedVia medical illustration team
Embryo biopsy for PGT
Tap a label to learn about that part.
A few trophectoderm cells (future placenta) are removed from a day 5–6 blastocyst for genetic testing. The inner cell mass is not touched. Using PGT to choose a baby's sex is illegal in India (PCPNDT Act).
Source: KedVia original diagram · KedVia medical illustration team
Types of PGT
| PGT-A | Number of chromosomes | Repeated miscarriage or failed IVF, older age (benefit debated) |
|---|---|---|
| PGT-M | One known gene disease (e.g. thalassaemia) | Both or one partner carries a gene condition |
| PGT-SR | Chromosome rearrangements | A partner has a balanced translocation |
Only for medical reasons, after genetic counselling. Never for choosing the baby's sex.
Source: KedVia original diagram · KedVia medical illustration team
Freezing eggs, sperm or embryos
| Process | Stimulation + egg retrieval | One or more semen samples | IVF, then freeze embryos |
|---|---|---|---|
| Time needed | About 2 weeks | Same day | 2–3 weeks |
| Partner needed | No | No | Yes, or donor sperm |
| Best done | Before 35 for better results | Any age, before cancer treatment | When a couple wants to store embryos |
Fertility preservation options, for medical or personal reasons.
Source: KedVia original diagram · KedVia medical illustration team
Egg freezing step by step
Step 1 of 5
AMH and scan
Estimates how many eggs may be collected.
Very similar to the first half of IVF.
Source: KedVia original diagram · KedVia medical illustration team
Donor treatment pathways
Medical reason confirmed
E.g. no eggs or very poor egg reserve, azoospermia, or genetic disease.
Counselling and consent
Both partners understand and give written consent.
Registered ART bank
Donors are screened; their identity is kept confidential by law.
Donor eggs
Donor's eggs are fertilised with partner's sperm; embryo goes to the recipient's womb.
Donor sperm
Used for IUI or IVF.
Donor embryos
Embryos donated by another couple through a registered bank.
Allowed in India only through registered ART clinics and banks, following the ART Act 2021.
Source: KedVia original diagram · KedVia medical illustration team
The treatment ladder
Lifestyle
Healthy weight, no tobacco or alcohol, good sleep.
Treat the cause
Thyroid, prolactin, TB, polyps, varicocele, etc.
Ovulation tablets
Letrozole or clomiphene with scans.
IUI
Washed sperm placed in the womb.
IVF / ICSI
Fertilisation in the lab.
Donor, surrogacy or adoption
Options when others are not possible.
Most couples start at the simplest suitable step. Your doctor may skip steps if needed.
Source: KedVia original diagram · KedVia medical illustration team
IUI vs IVF vs ICSI at a glance
| Main use | Mild male factor, unexplained, ovulation problems | Blocked tubes, endometriosis, failed IUI, low reserve | Severe male factor |
|---|---|---|---|
| Tubes must be open? | Yes | No | No |
| Pregnancy per cycle (under 35) | About 10–20% | About 35–50% | Similar to IVF |
| Clinic visits | 3–5 | 8–12 | 8–12 |
| Approximate cost (₹) | 5,000–25,000 | 1.2–2.5 lakh | 1.5–3 lakh |
Approximate ranges in India; individual results vary a lot with age and cause.
Source: KedVia original diagram · KedVia medical illustration team
Hysteroscopy
Step 1 of 5
After your period
Usually done in the first half of the cycle.
A thin camera looks inside the womb through the cervix — no cuts on the tummy.
Source: KedVia original diagram · KedVia medical illustration team
Laparoscopy (keyhole surgery)
Step 1 of 6
General anaesthesia
You are fully asleep.
A camera through tiny cuts near the navel to see and treat the pelvis.
Source: KedVia original diagram · KedVia medical illustration team
A typical IVF calendar
Step 1 of 9
Cycle day 2–3
Baseline scan and blood test; injections start.
Approximate timing for an antagonist cycle. Your clinic gives you your own exact calendar.
Source: KedVia original diagram · KedVia medical illustration team
IVF protocols compared
| Length | About 10–14 days of injections | 3–4 weeks including down-regulation | Few or no injections |
|---|---|---|---|
| OHSS risk | Lower; agonist trigger possible | Higher | Lowest |
| Eggs collected | Several | Several | 1–3 |
| Often used for | Most patients, PCOS/PMOS | Selected cases, endometriosis | Low reserve, wish for fewer drugs |
The doctor chooses a protocol based on age, AMH, past response and OHSS risk.
Source: KedVia original diagram · KedVia medical illustration team
IVF medicines and their jobs
| FSH / hMG | Grow several follicles | Daily injection under the skin |
|---|---|---|
| GnRH antagonist | Stop eggs being released too early | Daily injection from mid-stimulation |
| GnRH agonist | Quieten the ovaries (long protocol) or act as trigger | Injection or nasal spray |
| Trigger (hCG or agonist) | Final maturing of eggs | One injection at an exact time |
| Progesterone | Prepare and support the womb lining | Vaginal gel/tablet, injection or oral |
| Oestrogen | Build the lining in frozen cycles | Tablets, patches or gel |
General groups only. Never change or stop a medicine without your doctor's advice.
Source: KedVia original diagram · KedVia medical illustration team
Progesterone support after transfer
Step 1 of 5
Starts around retrieval
Progesterone usually begins on the day of or after egg retrieval, or before a frozen transfer.
After IVF the body may not make enough progesterone on its own, so it is given as medicine.
Source: KedVia original diagram · KedVia medical illustration team
OHSS: how serious is it?
| Symptoms | Bloating, mild tummy pain | More swelling, nausea, vomiting | Breathlessness, very little urine, severe pain, leg swelling |
|---|---|---|---|
| What to do | Rest, fluids, call clinic if worse | Contact the clinic the same day | Go to the nearest hospital now — call 108 or 112 |
| Higher risk | PCOS/PMOS, high AMH, many follicles | Same | Same, especially with pregnancy |
Ovarian hyperstimulation syndrome can happen after stimulation or the trigger. Severe OHSS is an emergency.
Source: KedVia original diagram · KedVia medical illustration team
Chance of a baby per IVF cycle by age (own eggs)
| Under 35 | About 35–45% |
|---|---|
| 35–37 | About 25–35% |
| 38–40 | About 15–25% |
| 41–42 | About 8–12% |
| Over 42 | Under 5% (higher with donor eggs) |
Approximate live birth ranges per started cycle from large international registries; clinics and individuals vary. Age matters most.
Source: KedVia original diagram · KedVia medical illustration team
Reviewing a failed IVF cycle
Review meeting
Go through the cycle together: response, eggs, embryos, transfer.
Embryo factors
Most failures are due to embryo chromosomes, which rise with age.
Womb check
Hysteroscopy for polyps, fibroids, scarring; check lining and hydrosalpinx.
Sperm check
Repeat semen test; DNA fragmentation in selected cases.
Change the plan
Different protocol, ICSI, freeze-all, PGT, or donor options if needed.
Emotional care
Take time; counselling helps.
A step-by-step review with your doctor before trying again.
Source: KedVia original diagram · KedVia medical illustration team
Diagnosing PCOS/PMOS: 2 out of 3
1. Irregular or no ovulation
Cycles shorter than 21 or longer than 35 days, or fewer than 8 periods a year.
2. High male-type hormones
Signs (acne, extra hair, hair thinning) or high testosterone on a blood test.
3. Polycystic ovaries
Many small follicles on ultrasound, or a high AMH in adults. Not used alone in teenagers.
Rule out look-alikes
Thyroid, high prolactin and other hormone problems are checked first.
Diagnosis
Any 2 of the 3 criteria, with other causes excluded.
Rotterdam criteria, updated by the 2023 international PCOS/PMOS guideline. Other causes must be ruled out first.
Source: KedVia original diagram · KedVia medical illustration team
PCOS/PMOS symptoms: why they happen and what helps
| Irregular periods | Ovulation does not happen regularly | Lifestyle, cycle-regulating medicines |
|---|---|---|
| Difficulty conceiving | No regular egg release | Letrozole, then injections, IUI or IVF |
| Acne / extra hair | Higher androgens | Skin care, medicines, hair removal |
| Weight gain | Insulin resistance | Balanced Indian diet, activity, sleep |
| Dark skin patches | High insulin | Same as above; check blood sugar |
| Low mood or anxiety | Hormones, stigma and stress | Talk to someone; talk to your doctor or a counsellor |
Every woman's PCOS/PMOS looks different.
Source: KedVia original diagram · KedVia medical illustration team
PCOS/PMOS fertility treatment ladder
Step 1 of 6
Lifestyle
Healthy eating, activity, sleep; 5–10% weight loss if overweight can restore ovulation.
Most women with PCOS/PMOS can conceive. Treatment usually starts with the simplest step.
Source: KedVia original diagram · KedVia medical illustration team
How insulin resistance affects the ovaries
Step 1 of 6
Food becomes sugar
Carbohydrates turn into glucose in the blood.
Why food, activity and sleep matter so much in PCOS/PMOS.
Source: KedVia original diagram · KedVia medical illustration team
PCOS/PMOS and long-term health checks
| Type 2 diabetes | Insulin resistance | Blood sugar / HbA1c every 1–3 years |
|---|---|---|
| Pregnancy diabetes | Higher risk in pregnancy | Early sugar test when pregnant |
| Cholesterol & BP | Heart health | Check regularly |
| Womb lining | Few periods can thicken the lining | At least 4 periods a year or doctor review |
| Mood & sleep | Anxiety, depression, sleep apnoea | Ask for help early |
PCOS/PMOS is a lifelong condition. Simple regular checks keep you healthy.
Source: KedVia original diagram · KedVia medical illustration team
Checking male fertility step by step
History
Past illness (mumps, TB, surgery), medicines, smoking, tobacco, alcohol, heat exposure, sexual problems.
Examination
Testis size, varicocele, vas deferens present on both sides.
Semen analysis
The key test; repeated if abnormal.
Hormones
FSH, LH, testosterone, prolactin when count is low or zero.
Scrotal ultrasound
For varicocele, blockages or lumps.
Special tests if needed
Genetic tests (karyotype, Y-chromosome) in very low or zero counts; DNA fragmentation in selected cases.
Men are checked from the very first visit — it is quick, simple and painless.
Source: KedVia original diagram · KedVia medical illustration team
Ways to collect sperm surgically
| How | Fine needle into epididymis or testis | Operating microscope to find best tubules |
|---|---|---|
| Best for | Blockage (obstructive) azoospermia | Sperm-production problems (non-obstructive) |
| Anaesthesia | Local or short | General or spinal |
| Recovery | 1–2 days | About a week |
Used for azoospermia (no sperm in semen). The sperm are then used for ICSI.
Source: KedVia original diagram · KedVia medical illustration team
Varicocele and fertility
Step 1 of 5
Swollen veins
Blood pools in veins above the testis.
Swollen veins in the scrotum, like varicose veins, usually on the left side.
Source: KedVia original diagram · KedVia medical illustration team
Which test on which cycle day?
| FSH, LH, oestradiol | Day 2–3 | Baseline levels before follicles grow |
|---|---|---|
| AMH, TSH, prolactin | Any day | Do not change much through the cycle |
| Antral follicle count scan | Day 2–5 | Small follicles easiest to count |
| HSG / sono-HSG | Day 6–11 | After bleeding, before ovulation |
| Follicle tracking | Day 9 onwards | Watch the follicle grow to ovulation |
| Progesterone | About 7 days before the next period | Confirms ovulation happened |
Typical timing for a 28-day cycle; your doctor may change it for your cycle.
Source: KedVia original diagram · KedVia medical illustration team
Endometriosis stages (ASRM)
| Stage 1 (minimal) | A few small surface spots | Mild |
|---|---|---|
| Stage 2 (mild) | More and deeper spots | Mild to moderate |
| Stage 3 (moderate) | Many spots, small chocolate cysts, some adhesions | Moderate |
| Stage 4 (severe) | Large cysts, dense adhesions, tubes or bowel stuck | Often needs IVF |
Stage describes how much and where — not how much pain you feel. Stage 1 can be very painful.
Source: KedVia original diagram · KedVia medical illustration team
Endometriosis: choosing a path
Diagnosis
Symptoms, examination, ultrasound or MRI; laparoscopy if needed.
Pain relief and hormones
When not trying to conceive; hormones stop ovulation so they pause fertility.
Laparoscopic surgery
Removes spots and adhesions; careful with ovarian cysts to protect egg reserve.
IUI with ovulation medicines
For mild disease with open tubes.
IVF
For moderate–severe disease, blocked tubes, low reserve, older age or failed treatment.
Treatment depends on pain, age, egg reserve, tubes and whether you are trying to conceive now.
Source: KedVia original diagram · KedVia medical illustration team
A fertility-friendly Indian plate
| Half: vegetables | Sabzi, salad, greens, seasonal fruit | Fibre, folate, antioxidants |
|---|---|---|
| Quarter: protein | Dal, chana, rajma, paneer, curd, eggs, fish, chicken | Steady sugar, muscle, iron |
| Quarter: whole grains | Millets (ragi, jowar, bajra), whole wheat roti, brown rice | Slow-release energy |
| Limit | Sweets, maida, fried snacks, sugary drinks, trans-fat vanaspati | Raise insulin and weight |
| Supplement | Folic acid for women trying to conceive (ask your doctor) | Prevents neural tube defects |
Simple, affordable, regional foods. No single food or 'fertility diet' guarantees pregnancy.
Source: KedVia original diagram · KedVia medical illustration team
Healthy weight for Indians (BMI)
| Underweight | Below 18.5 | Periods may stop; gain weight gently |
|---|---|---|
| Healthy | 18.5–22.9 | Best range for natural and IVF pregnancy |
| Overweight | 23–24.9 | Small weight loss can help ovulation |
| Obese | 25 and above | 5–10% weight loss improves chances and pregnancy safety |
Asian Indians have higher health risks at lower BMI, so Indian cut-offs are lower. BMI = weight (kg) ÷ height (m)².
Source: KedVia original diagram · KedVia medical illustration team
A 3-month plan before trying (both partners)
Step 1 of 7
Folic acid
Women: start folic acid at least 1–3 months before trying, as advised by your doctor.
Eggs and sperm take about 3 months to mature, so start healthy habits now.
Source: KedVia original diagram · KedVia medical illustration team